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Health Effects in Adults

For nonsmokers, breathing secondhand smoke has immediate harmful effects on the heart and blood vessels.1,3

It is estimated that secondhand smoke caused nearly 34,000 heart disease deaths each year during 2005–2009 among adult nonsmokers in the United States.1

Lung cancer1,7

Secondhand smoke exposure caused more than 7,300 lung cancer deaths each year during 2005–2009 among adult nonsmokers in the United States.1

Stroke1

Secondhand smoke can infiltrate into other units through hallways and stairwells.Larger infographic

Smokefree laws can reduce the risk for heart disease and lung cancer among nonsmokers.1

Patterns of Secondhand Smoke Exposure

Exposure to secondhand smoke can be measured by testing saliva, urine, or blood to see if it contains cotinine.3 Cotinine is created when the body breaks down the nicotine found in tobacco smoke.

Secondhand Smoke Exposure Has Decreased in Recent Years

Measurements of cotinine show that exposure to secondhand smoke has steadily decreased in the United States over time.

During 1988–1991, almost 90 of every 100 (87.9%) nonsmokers had measurable levels of cotinine.7

During 2007–2008, about 40 of every 100 (40.1%) nonsmokers had measurable levels of cotinine.7

During 2011–2012, about 25 of every 100 (25.3%) nonsmokers had measurable levels of cotinine.8

The decrease in exposure to secondhand smoke is likely due to:8

The growing number of states and communities with laws that do not allow smoking in indoor areas of workplaces and public places, including restaurants, bars, and casinos

The growing number of households with voluntary smokefree home rules

Significant declines in cigarette smoking rates

The fact that smoking around nonsmokers has become much less socially acceptable

Many People in the United States Are Still Exposed to Secondhand Smoke

During 2011–2012, about 58 million nonsmokers in the United States were exposed to secondhand smoke.8

Among children who live in homes in which no one smokes indoors, those who live in multi-unit housing (for example, apartments or condos) have 45% higher cotinine levels (or almost half the amount) than children who live in single-family homes.9

During 2011–2012, 2 out of every 5 children ages 3 to 11—including 7 out of every 10 Black children—in the United States were exposed to secondhand smoke regularly.8

During 2011–2012, more than 1 in 3 (36.8%) nonsmokers who lived in rental housing were exposed to secondhand smoke.8

Differences in Secondhand Smoke Exposure

Racial and Ethnic Groups8

Cotinine levels have declined in all racial and ethnic groups, but cotinine levels continue to be higher among non-Hispanic Black Americans than non-Hispanic White Americans and Mexican Americans. During 2011–2012:

Nearly half (46.8%) of Black nonsmokers in the United States were exposed to secondhand smoke.

About 22 of every 100 (21.8%) non-Hispanic White nonsmokers were exposed to secondhand smoke.

Nearly a quarter (23.9%) of Mexican American nonsmokers were exposed to secondhand smoke.

Income8

Secondhand smoke exposure is higher among people with low incomes.

During 2011–2012, more than 2 out of every 5 (43.2%) nonsmokers who lived below the poverty level were exposed to secondhand smoke.

Occupation10

Differences in secondhand smoke exposure related to people’s jobs decreased over the past 20 years, but large differences still exist.

Some groups continue to have high levels of secondhand smoke exposure. These include:

Blue-collar workers and service workers

Construction workers

What You Can Do

You can protect yourself and your family from secondhand smoke by:2,3,4

Quitting smoking if you are not already a nonsmoker

Not allowing anyone to smoke anywhere in or near your home

Not allowing anyone to smoke in your car, even with the windows down

Making sure your children’s day care center and schools are tobacco-free

Seeking out restaurants and other places that do not allow smoking (if your state still allows smoking in public areas)

Teaching your children to stay away from secondhand smoke

Being a good role model by not smoking or using any other type of tobacco